Countdown for Obamacare signups

The White House has been on a December dash to get people to sign up for health coverage by Monday, the first critical enrollment deadline for Obamacare — and the last sign-up opportunity for people who want their new health benefits to kick in on New Year’s Day.

The White House spent the past three weeks trying to move past the double-barreled disaster of the botched HealthCare.gov website and the millions of canceled health plans. The website now works, although not perfectly. Many of the people who received cancellation notices have found alternatives, though some are still scrambling to get health coverage by Monday.

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The rocky start of the health law rollout, a flurry of last-minute policy changes and shifting deadlines has consumers confused and advocates working overtime to get people over the sign-up finish line. Call centers have been beefed up, and outreach groups are texting and emailing people with reminders that the health care clock is ticking.

The law still faces stiff political headwinds, including from vulnerable Democrats. Sen. Joe Manchin (D-W. Va.), for one, warned Sunday that the law could still collapse “under its own weight.”

“If it’s so much more expensive than what we anticipated and if the coverage is not as good as what we had, you’ve got a complete meltdown at that time,” Manchin said in an interview aired Sunday on CNN’s “State of the Union.” “This transitional year gives you a chance to adjust the product for the market.”

“The idea here is these folks have shown a real concerted effort to want to get coverage,” said Purvee Kempf, deputy general counsel and chief policy adviser for the exchange, called DC Health Link.

The White House wants to avoid a spate of damaging stories on Jan. 1 about people who are newly uninsured, having had their old plans canceled. The administration badly wants to change the narrative to millions who are newly covered in private health plans in the exchanges or through Medicaid, which was expanded under the Affordable Care Act.

HealthCare.gov itself displays a message that captures that sense of urgency: “We are working around the clock to make sure that anyone who wants coverage starting on Jan. 1 enrolls by Dec. 23.” People can sign up until March 31, but their coverage would start later.

Insurers are anxious. They have to make sure that people are actually enrolled in the plans they selected, and the data they’ve gotten from the government, the so-called 834 files, have contained errors. The error rate has dropped sharply, HHS officials say, but with enrollment surging in late December, the health plans still have a huge task of reconciling their enrollment records with the government’s.

Polls show that deep opposition to the Affordable Care Act persists. Millions of Americans are angry, confused or both after weeks of revised dates, changed messages and intense political battle over sign-up rates, premium costs and the administration’s accountability. Just this past week, the White House announced that people who had a health plan canceled can get a “hardship” reprieve from the individual mandate — inviting critics of the law to question why the unpopular mandate isn’t being delayed for everyone else too.

Coburn encouraged people who are facing high costs after plan cancellations to take that option. “Everybody who signed up and has a high deductible policy should go and cancel,” he said.

The fact that Dec. 23 is the drop-dead date for January coverage is part of the administration’s triage effort. The original deadline was Dec. 15, but HHS pressed insurers to revise the timeline after all the lost time from the faulty website. And they moved the goalposts further last week, when they urged the insurance industry to accept premium payments from new customers as late as Jan. 10, as long as they signed up by Dec. 23.

President Barack Obama announced at his year-end news conference that enrollment was rising after those anemic numbers in October and November. As of last week, more than a million people had signed up for coverage in the health insurance exchanges and about 4 million has been found eligible for Medicaid and the Children’s Health Insurance Program, the White House said. And the pace of enrollment has quickened.

“Millions of Americans, despite the problems with the website, are now poised to be covered by quality, affordable health insurance come New Year’s Day,” the president said. “Now, this holiday season, there are mothers and fathers and entrepreneurs and workers who have something new to celebrate — the security of knowing that when the unexpected or misfortune strikes, hardship no longer has to.”